I can't stop hiccupping — Help!

Dear Reader,

Hiccups happen when the diaphragm, the big dome-shaped muscle at the bottom of the chest cavity that helps with breathing, spasms. The diaphragm is controlled by the phrenic nerve, and sends messages to the brain via the phrenic and vagus nerves. When these nerves become irritated, they cause the diaphragm to contract suddenly, resulting in the familiar hiccup.

Some of what can irritate the vagus and phrenic nerves, and thus the diaphragm, include:

• Eating too quickly
• Eating hot and/or spicy foods
• Drinking hot liquids
• Drinking alcohol
• Nervousness
• Excitement
• Pneumonia, pleurisy (inflammation of the lining of the lungs), tumors, pancreatitis, hepatitis
• Conditions that irritate the area of the brain responsible for hiccupping, such as a tumor or stroke
• Tourette's syndrome and other conditions that involve involuntary movements (tics)

While there are no sure-fire ways to rid yourself of the hiccups, lots of fascinating folk remedies are touted to do the job, including these favorites:

• Asking someone to startle you (so that you'll gasp in surprise)
• Holding your breath or breathing into a paper bag
• Drinking ice water or sucking on an ice cube
• Eating a spoonful of sugar, honey, or peanut butter
• Sprinkling salt on a lemon half and then sucking on the lemon
• Drinking from the far side of a glass
• Drinking water through a cloth

Interestingly enough, many of these remedies involve activities that actually make biologic sense as hiccup-interrupters. For example, when a person holds his or her breath or breathes into a paper bag, s/he increases his/her body's concentration of carbon dioxide, which interferes with the diaphragm's ability to contract. When someone eats or drinks certain items, s/he stimulates the vagus nerve, which may interrupt the signal that results in a hiccup.

Only rarely are cases of the hiccups caused by serious disease. In your case, the hiccups have a particular pattern, and the pattern seems to be changing to more frequently. As a result, when hiccups last a particularly long time, are particularly disruptive, or you notice a change or increase in the hiccup pattern, checking with your health care provider is a smart move.